When a pediatrician told Sommer Poquette that her then-4-year-old daughter was overweight, the Michigan mom knew what she was not going to do: She was not going to give her preschooler a complex about her waistline.

Having struggled with her own weight her whole life — and remembering the rampant overeating, ridicule and embarrassment that kicked in during the third grade — Poquette was determined to treat her daughter’s health issue without turning it into a mental-health issue.

“Children have such fragile self-esteems,” she said. “I know how fragile because I remember the third grade, and I don’t want her to face those similar struggles.”

One third of all children in the US are overweight, and 17% are obese. It is long past time for parents to intervene, doctors say. But for too many families, the balance between preserving a child’s self-esteem and addressing a real and life-threatening health risk prove too difficult to manage.

A recent poll sponsored by WebMD and Sanford Health revealed that parents would rather talk to their kids about the birds and the bees than about burgers and cheese: Nearly 22% of all parents polled said the idea of chewing the fat about weight made them queasy, whereas only 12% felt any unease about discussing sex with their teens.

Instead of dealing with their pudgy progeny, parents often choose to sweep their kids’ weight issue under the rug of denial, declaring their obese children will “grow out of it.” When parents do address their kids’ growing waistlines, it often comes off as harsh and hypocritical — lecturing and criticizing their children for the sedentary lifestyle and poor diet choices that they engage in themselves.

It’s these types of parenting pitfalls that frustrate Dr. Dan Cooper, chair of the department of pediatrics at University of California, Irvine and a noted childhood-obesity expert.

“We forget how serious this is. When you look at the number of deaths, there are more associated with childhood obesity than with childhood leukemia,” Cooper said. “We’re having a hard time making a dent in this obesity epidemic.”

Without family involvement, that struggle will continue, said Cooper, one of the principal investigators in a nationwide NIH-funded study that found that tackling the problem in schools only — through healthy lunch options and improved physical-education classes — resulted in only moderate success for most overweight kids.

Still, he and other experts agree that when parents do proceed to address the issue, they must do so cautiously.

“I’m not a big fan of calling your kid ‘fat’ and saying, ‘Let’s do something about it,’ ” said Emily Ets-Hokin, clinical assistant professor of psychiatry at SUNY Buffalo School of Medicine. “I don’t recommend it, and I think it’s always going to backfire.”

Emily Sanford is living proof.

Growing up in Georgia, Sanford remembers the weekly dinners her Chinese immigrant father would take his southern family to at the only “authentic” Chinese restaurant in town. Sanford’s little sister — a petite wisp of a girl — was welcomed to eat anything she liked: deep-fried shrimp, BBQ pork, fried ice cream.

Not Sanford.

“Built line a linebacker,” as she says, Sanford regularly accompanied her heavyset southern mom to weekly workouts, was dragged to a child psychologist and was put on weight-loss drugs at 14.

“I never got to eat the fried ice cream,” said Sanford, 31, who ballooned to 455 pounds in adulthood and now blogs about her weight-loss journey under the moniker Skinny Emmie. “When you’re a little kid, it’s pretty obvious when you’re singled out. It’s like, ‘Oh, I see how it is.’ ”

Instead of targeting the one “fat kid” in the family, parents like Poquette have begun making lifestyle changes that apply to the whole family — including herself.

“It’s become a family thing,” said Poquette, who has lost 40 pounds in the nearly two years since her family began to change its habits. “Instead of saying, ‘Let’s go for a bike ride to get ice cream,’ it’s become, ‘Let’s go for a bike ride.’ ”

Poquette has involved her kids in grocery shopping and cooking and asks her children — and her spouse — to consider whether they are reaching for a snack out of hunger or boredom.

“We’ve never sat down and said, ‘Mom’s overweight and Josephine’s overweight, so this is what we’re going to do about it,’ ” said Poquette, whose husband and 7-year-old son are both slim. “We’ve just presented it like, as parents we’re making new lifestyle changes for our family. You get two pieces of Halloween candy, not 10.’ That’s across the board for everybody in the family.”

Poquette likens modeling good eating habits to any other lifestyle choices they hope to impart on their kids — like voting or recycling.

“Your goal as a parent is to raise children who make good decisions,” she said.

This modeling approach is probably the best method parents can employ to address the weighty issue of childhood chub without making a kid feel awkward or ostracized, Ets-Hokin said.

But parents have to first admit that there is a problem and that they play a role in it. Too many overweight parents drag junior to the doctor’s office without first taking a look at their own bad habits, Cooper said.

Another approach parents are urged to consider is simply listening.

“It’s better to follow the kid’s lead and look for opportunities to discuss them,” Ets-Hokin said. “Saying, ‘You’re getting a little pudgy,’ that’s a don’t. But if the child says, ‘I don’t like the way this looks on me,’ that might be an opportunity.”

Also, parents need to consider the reason for a child’s overeating, said Ets-Hokin. Sometimes it’s environmental, sometimes it’s genetic. But other times, it’s a form of communication.

“It could be that the overeating is triggered by something that is going on in the family,” she said. “The trick is to listen, not lecture. If you follow your child’s lead, you’ll have a better shot at hearing what is really going on.

“If you’ve got an adolescent girl who is developing breasts and it makes her uncomfortable, you wouldn’t want to start the conversation with, ‘I’ve noticed you’ve been eating a lot,’ ” Ets-Hokin said. “Try, ‘How are things going at school? Boys sure can be rough. What’s going on?’”

Regardless of what’s causing the weight problems, Sanford and others warn parents to approach their kids with kid gloves.

“My father’s words were sharp, like razors,” Sanford said. “He’d say, ‘You’re disgusting. You’re so gross.’ When you make [weight] the focus of your child’s life, the child thinks, ‘There is something wrong with me.’

“That’s always something I had in the back of my mind, even before children ever teased me.”